Tribal Transportation Safety Assessments: Online Survey & Intake Application
Tribal sites will be evaluated by professional transportation safety experts based upon this online survey and intake application, as well as other data available. This technical-assistance program is available to federally-recognized tribes who are successful in getting a grant from the FHWA Tribal Transportation Program Safety Funds (TTPSF) for FFY2017/18.

Please complete this online survey in its entirety so that we can evaluate the need for a transportation safety assessment for your Tribe. You may print the PDF version of the survey as a guide in doing this online survey. Once you submit the online survey, you will be able to change your answers in this survey later, when you have more information to enter. Please note: If you have submitted the electronic version of this application, please do not submit another application.

As an alternative to completing the online survey, you may submit your completed intake application by fax to: 510-643-3955, or you may scan and email to: t2sa@techtransfer.berkeley.edu.

1. Official Name of Tribe
2. Your name
Primary point of contact
● Your title or position
● Street address
● City
● County
● State
● Zip Code
● Phone
● Email
● Website
3. Please specify the following information for your Tribe.
If the information is not available at this time, please specify the reason below.
● Population living on Tribal Land
● Tribal Land area in square miles
● Miles of roads within RIFDS (Road Inventory Field Data System)
● Percent of paved roads
4. What is the major traffic/trip generator or travel destination within the Tribal area? Please select all that apply.
Required
5. What is the nature of the safety issues or concerns related to transportation, traffic, mobility, and access that you wish to be evaluated in your Tribal community? (Check all that apply)
Required
6. Which of the following technical professional expertise do you think would be most helpful in conducting the transportation safety assessment for your Tribe? Please check your top priority below:
7. If you have multiple transportation safety assessment needs, please check your secondary priority below:
8. Please briefly describe the top priority transportation or traffic safety concern or issue you have on your Tribal land.
9. Please specify the areas where you have traffic safety concerns. Please identify the intersection(s), roadway(s), geographic area(s) where the most frequent injury or loss of life have occurred in the past 36 months.
10. What type of traffic-related or traffic-safety data is collected and maintained by your Tribe? (Check all that apply)
Required
11. In the last 12 months prior to this survey, how many fatalities, if any, of each type below resulting from traffic, vehicular, or auto collisions have occurred on your Tribal land?
If collision data is not collected on your Tribal land, please indicate the reason here:
● Total fatalities
Fatality
Fatality
● Pedestrian fatalities
Fatality
Fatality
● Bicycle fatalities
Fatality
Fatality
● Motorcycle fatalities
Fatality
Fatality
If the fatality number is greater than 10 for any of the questions above, please indicate the total fatalities here.
12. Has there been any analysis of traffic safety or traffic engineering studies conducted in your Tribal community in the past 36 months?
If yes, please list the traffic studies and dates. Please provide details of what can be made available for this study.
13. Has the Tribal Council drafted and/or adopted any official or formal planning documents outlining future land development growth and/or supporting transportation infrastructure improvements (for example: general plan, comprehensive plan, master plan or long-range transportation plan, transportation improvement plan, or traffic safety plan)?
If yes, please list the planning document names and dates:
14. Are there any proposed, planned, or programmed transportation infrastructure capital improvements within the next three years?
If Yes, the experts assigned to your Tribe (if your Tribe is selected) will request access to your transportation infrastructure capital improvements document.
Please provide details of what can be made available for this study.
15. How many intersections within the Tribal land are controlled by traffic signal lights?
Intersections
Intersections
If more than 10 signalized intersections, enter the total number below:
16. How would you rate the level of traffic congestion on the Tribal land?
17. Is traffic safety enforced in your Tribal community?
If Yes, which agencies provide the traffic safety enforcement?
18. Does your Tribe have staff in engineering and/or planning with the resources to address transportation/traffic safety issues? Do you have a Transportation Department?
19. Please list any location(s) where excessive vehicular speeding may occur. Please indicate how clear or effective the traffic or roadway signs are at each location.
20. Please list the number of schools on your Tribal land.
Schools
Schools
For the schools, please indicate the grade levels served and describe the ease of walking and/or bicycling for school-age children (under 18 years old).
Need Assistance?
Please complete this online survey and intake application in its entirety so that we can evaluate the need for a transportation safety assessment for your Tribe. If you need help in filling the information for this survey, please contact Tech Transfer at t2sa@techtransfer.berkeley.edu.

For more information on the project, please our website at: www.techtransfer.berkeley.edu/t2sa

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